Appeals & Complaints

If you or an authorized representative wish to file an Appeal or Complaint, you may call Cigna-HealthSpring Member Services toll free at 1-877-653-0327 (TTY 711) Monday to Friday, 8 a.m. to 5 p.m. Central Time, excluding state-approved holidays. If the call is after hours, please leave a message and your call will be returned within 1 business day.

For all services other than Prescription Drugs/Pharmacy you can fax your Expedited Appeal to 1-877-809-0783 or mail your request to:

If you, as a member of the health plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A doctor or other medical provider may be your representative. If you want to challenge a decision made by your health plan, you or your representative must ask for the fair hearing within 90 days of the date on the health plan’s letter with the decision. If you do not ask for the fair hearing within 90 days, you may lose your right to a fair hearing.

To ask for a fair hearing, you or your representative should either send a letter to the health plan at:

If you ask for a fair hearing, you will get a packet of information letting you know the date, time and location of the hearing. Most fair hearings are held by telephone. At that time, you or your representative can tell why you need the service the health plan denied. HHSC will give you a final decision within 90 days from the date you asked for the hearing.

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